Provider Demographics
NPI:1538587944
Name:PALMER CHIROPRACTIC INC
Entity type:Organization
Organization Name:PALMER CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-368-7782
Mailing Address - Street 1:660 N STATE ROAD 7
Mailing Address - Street 2:UNIT 10
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2117
Mailing Address - Country:US
Mailing Address - Phone:954-368-7782
Mailing Address - Fax:954-635-2568
Practice Address - Street 1:660 N STATE ROAD 7
Practice Address - Street 2:UNIT 10
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2117
Practice Address - Country:US
Practice Address - Phone:954-368-7782
Practice Address - Fax:954-635-2568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-02
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10495111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014689200Medicaid